Prevalence of bottle feeding practice and its associated factors among mothers of infants age less than six months in Addis Ababa, Ethiopia, 2022. Multi center cross sectional study.

Prevalence of bottle feeding practice and its associated factors among mothers of infants age less than six months in Addis Ababa, Ethiopia, 2022. 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Multi center cross sectional study. Gedefaw Birhan, Shikur Mohamed, Sisay Tenia, Mulugeta Taybele, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6635963/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction : Bottle feeding practice should be avoided due to its influence on optimal breastfeeding and its effect associated with morbidity and mortality resulting from diarrheal disease, infant and child illness, and malnutrition. This study is aimed to assess the prevalence of bottle-feeding practice and its associated factors among mothers of infants less than six months in Addis Ababa. Methods An institution-based multi center cross-sectional study was conducted among 456 mothers who had infants less than six months in Addis Ababa visiting hospitals for MCH Service. Data were collected through interview, entered using Epi info version 7.1 and exported to statistical package for social science version 26 for analysis. Variables with p-value < 0.25 in bivariable binary logistic regression analysis were entered to multivariable logistic regression analysis. Finally, variables with p-value < 0.05 in multivariable logistic regression were taken as significant factor. Results The overall prevalence of bottle-feeding practice in Addis Ababa is 39%. Being male infant (AOR = 0.589; 95%CI: 0.381, 0.911), infant hospitalization (AOR = 2.114; 95%CI 1.246, 3.588), cesarean section delivery (AOR = 2.817; 95%CI: 1.764, 4.496), late initiation of breastfeeding (AOR = 5.526; 95%CI: 3.121, 9.786) and not having information on breast feeding (AOR = 4.13; 95%CI 2.21, 7.73) were statistically significant factors associated with bottle feeding practice. Conclusion The magnitude of bottle-feeding practice is high in Addis Ababa. Being male infants, infants hospitalized, cesarean section delivery, late initiation of breastfeeding and not having information on breast feeding were significant factors for bottle feeding practice. Greater efforts to promote breastfeeding should be targeted towards women with sub-optimal breastfeed. Nutrition & Dietetics bottle feeding prevalence associated factors Addis Ababa Ethiopia Figures Figure 1 Figure 2 Introduction Adequate nutrition during the first two years of a child’s life is essential to lower morbidity and mortality, reduce the risk of chronic diseases, normal development and the future well-being of the child( 1 ). The World Health Organization (WHO) recommends Optimal infant and young child feeding practices which includes early initiation of breastfeeding within an hour of birth, exclusive breastfeeding up to six months of age, introduction of complementary feeding at six months and continuing breast-feeding up to 2 years or beyond and ensuring proper use of breast-milk substitutes( 2 ). Bottle-feeding is an infant feeding modality that has been in existence since ancient times and currently a significant number of infants are being fed via a bottle with either breast milk or breast milk substitutes (formula)( 3 ). Globally, 59% of infants and around 85% of infants within Australia by five months of age are being fed with either breast milk or formula using bottles( 4 ). Breastfeeding is declining in almost all over the world despite its nutritional and immunological advantages. Improper breastfeeding practices may significantly compromise the health, development and survival of infants, children, and mothers( 5 ). Worldwide it causes 820,000 children and 20,000 maternal deaths in a year. It has been also found that non-exclusive breast-feeding (bottle feeding) in the first 6 months of life results in 1.4 million deaths and 10% of the disease burden in children younger than 5 years( 6 ). Bottle feeding practices in infancy and childhood led to the high prevalence of malnutrition, increased morbidity and mortality in children in the developing world( 6 ). Malnutrition accounts for around two-thirds of all deaths among children under the age of five worldwide. Each year more than 10 million children die as a result of malnutrition; 98% of these deaths occur in underdeveloped countries( 5 ). Death rates in third world countries are lower among breastfed babies and breastfed babies have lower infections than formula fed babies( 7 ). In Ethiopia suboptimal breastfeeding practices are the most contributor around 70,000 infant deaths per year; 24% of the total infant death annually and that be significantly prevented by nutrition interventions such as exclusive breastfeeding( 8 ). Bottle feeding is one of the major causes of diarrhea among the infants. The rate of bottle- feeding practice keeps on increasing among the mothers with infants older than four months due to early weaning( 9 ). The major reasons for bottle- feeding practice include insufficient breast milk, the need to go back to work, maternal work load and illness, delayed ANC follow up, caesarean section mode of delivery and improper birth spacing ( 2 , 9 – 13 ) Even though, WHO recommends avoidance of bottle feeding, there is a current shift from traditional feeding practice(bottle feeding) towards shorter breast feeding and introduction of bottle-feeding in developed countries and urban communities of developing countries ( 7 ). Practice of bottle feeding and associated factors are rarely addressed in urban community of Ethiopia including Addis Ababa. So, this study aimed to fill this gap and assess the prevalence of bottle-feeding practice and associated factors among mothers of infants less than six month in Addis Ababa, Ethiopia. Methods Study area and period The study was conducted in selected public hospitals of Addis Ababa, Ethiopia. There are 41 hospitals in Addis Ababa, including 13 public and 28 private ones. Out of the 13 government hospitals 03 public hospitals was selected for this study and out of 28 private hospitals 07 hospitals was selected for our study. The city has almost 4 per cent of the Ethiopian populations with 11 per cent of under five-year children. The total population of Addis Ababa is 3,602,000; 1,134,150 are under five children according to 2019 projection based on the 2007 census( 14 ). In Addis Ababa there are around 116 health centers in eleven sub cites ( 15 ). Study Design An institutional based cross sectional study design was conducted Study Population and eligible criteria All mothers who have infants less than six months in Addis Ababa were considered in the study. Those mothers who have infants less than six months at selected hospital were included in the study. Mothers who have repeated visits during the study period will be excluded from the study. Sample Size Determination The sample size required for the study is calculated using epi info application or the formula of simple proportion estimation: n = n = [(Z α/2 ) 2 (p) (1-p)]/d 2 Where; n- The minimum sample size required, P- proportion of bottle feeding associated factor in study done at woldia hospital, maternal age 35–50 years (23.4%)( 16 ). Z𝛼2⁄- Standard normal value at (1- α) 95% confidence level, = 95%, margin of error (d) = 5% and design effect (de) = 1.5 is used, The sample size “n” for associated factor of bottle feeding = (1.96) 2 (0.234) (1-0.234)/ (0.05) 2 = 275, since study uses multi stage sampling, 1.5 design effect was used then the sample size would be 414.The final sample size after addition of 10% non-response rate was 456. Sampling technique Multi stage sampling technique was employed to include study participants in to the research. The registration of mothers who have infant less than 6 months on expanded program of immunization register was used to get list of children from each Hospital. Sample from each hospital was determined by using proportion allocation to the sample size. Finally, systematic random sampling technique was used to select a representative population in the immunization unit. The sampling interval (K) was established by dividing the average number of women who visited the immunization unit in the previous two months before data collection (average n = 2660) by the sample size, which produced K = 2660/456 = 6. Women were recruited daily by simple random sampling technique using the lottery method, and the next respondent was selected by adding a sampling interval to the number of the selected women. The same procedure was done on subsequent days until the required sample size was reached. Proportional allocation In three selected sub cities there were 2660 children less than 6 months of age. Out of this 335 in Beta health center, 277 in Simegn Kebede health center from Areda sub city, 360 in woreda 1 health center, 431 in woreda 3 health center and 245 from woreda 4 health center of Kolife Karanio sub city and 365 in woreda 2 health center, 347 woreda 10 health center and 300 from woreda 5 health center of Nifas silk lafito sub city. Based on proportional allocation to size, 456 study subjects were distributed to Beta health center (57), Simegn Kebede health center(47) from Areda sub city; woreda 1 health center (42), woreda 3 health center(74) and woreda 4 health center(62) of Kolife Karanio sub city and woreda 2 health center (63), woreda 10 health center (60) and 300 from woreda 5 health center(51) of Nifas silk lafito sub city. Data collection procedure Data was collected by face-to-face interview using semi-structured pretested questionnaire. The questionnaire was administered through face-to-face interview by five ( 5 ) trained data collectors (diploma nurse) and the data collection was supervised by two BSC health worker. The questionnaire was constructed by adopting and modifying from previous studies( 2 , 10 , 12 , 16 ). First, the questionnaire was prepared in English then translated into Amharic (local language) and then back to English to check consistency. The quality of the data collection process was monitored, and clear uniform instructions were given to all data collectors. All data collected as a part of this study was checked by the principal investigator. Operational definitions Exclusive breastfeeding A mother gives to infant only breast milk ( 5 ). Maternal illness : Mothers difficulty to breastfeed an infant due to illness(breast illness related problem) ( 5 ). Mixed breastfeeding : if an infant took breast milk with addition of liquid foods like cow milk and formula milk and soft foods( 5 ). Adequate knowledge If a mother answers half and above correctly from questions which are asked to measure bottle feeding knowledge ( 17 ). Inadequate knowledge If a mother answers below half correctly from questions which are asked to measure bottle feeding knowledge ( 17 ). Late initiation of breastfeeding initiation of breast milk after one hour after delivery( 5 ). Bottle feeding Mother uses bottle for Brest milk and or breast milk substitutes (formula or others)( 18 ). Data Quality Control The principal investigator undergoes quality assessment on ongoing supervision each day during data collection to ensure quality of data by checking filled format for their completeness’s and consistency. Data reliability was checked by considering the Cronbach alpha which is greater than or equal to 0.5 and Multicollinearity between variables was also checked by considering variance inflation factor (VIF) which is less than 2 which indicates there is no correlation between independent variables. Data management and analysis Data obtained from institution-based survey was checked for completeness & inconsistencies, then coded, entered and cleaned in the Epi info version 7.1 and Microsoft excel and analyzed using Statistical package for Social Sciences (SPSS) version 26. After categorizing and defining variables, descriptive analysis was carried out for each of the independent variables using frequencies, cross tabulation and percentages: then presented by text, tables and chart. Binary logistic regression analysis model was used to assess the association between bottle feeding and associated factors. Variables with p-value < 0.2 in bivariable binary logistic regression analysis were entered to multivariable binary logistic regression analysis. Finally, variables with p-value < 0.05 in multivariable logistic regression were taken as significant factor. Adjusted odds ratio with 95% CI was used to show the strength of association between the dependent and independent variables. Model fitness was tested with Hosmer and Lemeshow Goodness of Fit test and fit with a p-value = 0.440. In addition, there was no problem of Multicollinearity among explanatory variables, with variance inflation factor < 3 for all variables. Ethical considerations Ethical clearance was obtained from the institutional review board of Saint Paul hospital millennium medical collage ethical review committee (ref.no. PML3/757, on 9/6/2022) and Addis Ababa health bureau public health research and emergency management department (ref.no. A/A/16172/227, on 23/6/2022). The participants were then fully briefed about the study’s purpose and benefits in their local language and obtained informed written consent for both data collection and publication. Confidentiality was maintained through anonymity and privacy measures were taken to preserve the right of the participants throughout the research work including publication. Finally, the selected participants were asked about their willingness to join the study. Any study participant willing to engage in the study and those who wanted to stop an interview at any time were allowed to do so. This study was conducted in accordance with the Declaration of Helsinki. Results Socio-demographic characteristics In this study, a total of 451 study participants were included with a response rate of 98.9%. Among the study participants most of the study participants, 444 (98.4%) were married. Regards to religion more than half 235 (52.1%) were orthodox. Related to occupation, 202 (44.8%) of mothers were house wife. ( Table 1 ). Table 1 Socio-demographic characteristics mothers (respondents) who have infants less than six months old, in Addis Ababa: Ethiopia, 2022. Variable Categories(N = 451) frequency Percent Mothers age(years) 18–23 118 26.2% 24–29 202 44.8% 30–35 94 20.8% above 35 37 8.2% Marital status Married 444 98.4% Other 7 1.6% Religion orthodox Christian 235 52.1% Muslim 128 28.4% Protestant 76 16.9% Catholic 12 2.7% Maternal education unable to read and write 31 6.9% primary school 139 30.8% secondary and preparatory 169 37.5% higher education 112 24.8% Husbands’ education unable to read and write 8 1.8% primary school 105 23.3% secondary and preparatory 169 37.5% higher education 169 37.5% Maternal occupation Housewife 202 44.8% government employ 69 15.3% private organization employee 79 17.5% Merchant 76 16.9% daily labor 25 5.5% Husbands’ occupation government employ 101 22.4% private organization employee 133 29.5% Merchant 141 31.3% daily labour 76 16.9% Monthly household income 1500–4500 birr 89 19.7% 4501–7500 birr 162 35.9% 7501–10000 birr 127 28.2% above 10001birr 73 16.2% Others = single and divorced N = number Obstetric and health service utilization factors In this study, 449 (99.6%) mothers had antenatal care in their previous pregnancy. During their antenatal care follow up, 87 (19.6%) of women did not receive counseling about infant feeding practice. The majority of the respondents 437(96.9%) were give birth at health institution and 14 (3.1%) were give birth at home. From 356(78.9%) of mothers received postnatal care, 289 (69.2%) had received counseling on infant feeding up to six months ( Table 2 ) . Table 2 Obstetric and health service utilization characteristics of study participants in Addis Ababa, Ethiopia, 2022. Variable Response (N = 451) frequency Percent Infant age 0–3 month 332 73.6% 4–6 month 119 26.4% Infant sex Male 268 59.4% Female 183 40.6% Numbers of children 1 196 43.5% 2–5 254 56.3% Six and above 6 1 0.2% Birth order First 195 43.2% Second 180 39.9% Third 59 13.1% fourth and above 17 3.8% Birth interval from preceding birth 1–2 94 36.4% 3–4 119 46.1% above 4 45 17.4% ANC follow up Yes 449 99.6% No 2 0.6% Receive infant feeding counseling during ANC visit(N = 449) Yes 362 80.6% No 87 19.4% Place of delivery health institution 437 96.9% Home 14 3.1% Mode of delivery cesarean section 120 26.6% spontaneous delivery 331 73.4% Infant hospitalization Yes 87 19.3% No 364 80.7% PNC follow up within 45 days of delivery Yes 356 78.9% No 95 21.1% receive infant feeding counseling during PNC visit(N = 356) Yes 289 79.2% No 76 20.8% N = number Prevalence of bottle feeding practice Prevalence of Bottle feeding practice was 39% (95%CI 35, 44). The following figure shows the prevalence of bottle feeding practice among mothers who have infants less than six month (Fig. 1 ). Among respondents who used bottles for feeding, 103 (58.9%) used formula, 30(20.8%) used expressed breast milk and 5(3.5%) used caws milk. In this study influential bodies of mothers to start bottle fed were health professional 67(30.7%), husbands 40(18.3%) and mothers 17(7.8%) (Table 3 ). Bottle feeding related factors All mothers have breastfeed their current infant for a certain period of time. From total, 122 (27.1%) mothers initiated breast milk to infant immediately within one hour of birth and 131(29%) mothers initiated breast milk to infant after one hour of birth, where as103(22.8%) initiates breast feeding after mother feels comfort after delivery. In this study, Influential bodies of mothers to start bottle feeding were health professional 67(30.7%), husbands 40(18.3%) and mothers 17(7.8%). Table 3 Bottle feeding related practices of mothers who have infants less than six months old in Addis Ababa: Ethiopia, 2022. Variable Response Frequency Percent Initiation of breast feeding immediately after birth 122 27.1 after one hour 131 29 when mother feels comfort 103 22.8 I did not feed breast milk 95 21.1 Kinds of fluid you feed if not breast feed(N = 144) caws milk 5 3.5 formula milk 109 75.7 expressed breast milk 30 20.8 Youngest infant currently feed breast feeding 275 61.0 bottle feeding 176 39.0 Bottle feeding(N = 451) Yes 176 39.0 No 275 61.0 Duration of bottle feed(N = 156) 0–3 month 134 76.1 4–6 month 42 23.9 Influence to bottle feed (N = 218) own decision 92 42.2 Mother 17 7.8 Husband 40 18.3 health professionals 67 30.7 friends or family 2 0.9 The following diagram also shows the reason why mother who have infants less than six month practice bottle feeding (n = 209) ( Fig. 2 ). Mothers’ knowledge and information source of bottle feeding Around two third (61.4%) of mother's who have infant less than six month have adequate knowledge on bottle feeding, where as 38.6% of mother's who have infant less than six month haven’t adequate knowledge on bottle feeding. Regarding to information about bottle feeding 352(78.3%) mothers were informed about bottle feeding from different sources (Table 4 ). Table 4 Information and source information on bottle feeding among mothers who have infants less than six months old in Addis Ababa: Ethiopia, 2022. Variable Response Frequency Percent Have you ever heard bottle feeding Yes(informed) 353 78.3% No (not informed) 98 21.7% Source of information on bottle feeding(N = 353) mass media 66 18.7% health facilities 136 38.5% friends and family 149 42.2% books and leaflets 2 0.6% Maternal knowledge on bottle feeding inadequate knowledge 174 38.6% adequate knowledge 277 61.4% Factors associated with bottle feeding practice Binary logistic regression model was used to determine the association between independent variables with dependent variable. Variables which were associated with bottle feeding practice in the bivariable binary logistic regression analysis (P < 0.2) were; sex of infant, initiation of breast milk, mothers education, place of delivery, mode of delivery, monthly household income, infant hospitalization, information herd about bottle feeding and mothers knowledge about bottle feeding. Variables which were associated in bivariable binary logistic regression analysis were tested in the final multivariable binary logistic regression analysis to see their significant association with bottle feeding practice. By using backward likelihood ratio method multivariable logistic regression analysis; infant sex, infant hospitalization, mode of delivery, heard about bottle feeding and initiation of breast milk were remained significant in the final model. Model fitness was tested with Hosmer and Lemeshow Goodness of Fit test and fit with a p-value = 0.440. In addition, there was no problem of Multicollinearity among explanatory variables, with variance inflation factor < 3 for all variables. After adjusting confounding variables the finding of this study revealed that the odds of bottle feeding practice among mothers having infants less than six months who had male infant were 59% less likely to bottle feed than infants of female sex [AOR = 0.589(95%CI: 0.381, 0.911)]. Mode of delivery was significantly associated with bottle feeding practice. mothers who gave birth through cesarean section were 2.8 times more likely to practice bottle feed than mothers give birth via spontaneous delivery [AOR = 2.817 (95%CI: 1.764, 4.494)]. Similarly, infant hospitalization after delivery is significant for mothers to bottle feed an infant. Infants who were hospitalized after delivery were almost 2 times more likely to practice bottle feeding than infants who were not hospitalized [AOR = 2.114(95%CI: 1.246, 3.588)]. In addition, time of initiation breast feed was significantly associated with bottle feeding practice. Mothers who initiate breast fed after one hour were 5.5 times more likely to practice bottle feeding than mothers who initiate breast feed immediately after birth (within one hour) [AOR = 5.526(95%CI: 3.121, 9.786)]. Furthermore, mothers who have no information on bottle feeding was significantly associated with bottle feeding practice. Lastly, Mothers not having information about bottle feeding were 4 times more likely to practice than mothers not having information about bottle feeding [AOR = 4.131(95%CI: 2.208, 7.729)] (Table 5 ). Table 5 Bivariable and multivariable logistic regression analysis for factors associated with bottle feeding practice among mothers having infant less than 6 months at Addis Ababa health centers, Addis Ababa, Ethiopia, 2022. Variable Bottle Feeding Frequency Yes No COR AOR P value Infant sex Male 93 175 0.64(0.436, 0.941) 0.589(0.38,0.9) 0.017 Female 83 100 1 Maternal education unable to read and write 10 21 0.476(0.21,1.10) primary school 43 96 0.448(0.27,0.75) secondary and preparatory 67 102 0.657(0.40,1.06) higher education 56 56 1 Monthly household income 1500–4500 birr 32 57 0.414(0.22, 0.78) 4501–7500 birr 49 113 0.320(0.18, 0.57) 7501–10000 birr 53 74 0.528(0.29,0.94) above 10001 42 31 1 Place of delivery health institution 173 264 2.403(0.66,8.74) Home 3 11 1 Mode of delivery caesarean section 77 53 3.258(2.14,4.97) 2.82(1.76, 4.5) < 0.001 spontaneous delivery 99 222 1 Infant hospitalization Yes 51 41 2.329(1.46,3.71) 2.11(1.25,3.59) 0.006 No 125 234 1 Time of initiation of breast feeding after one hour(late) 157 172 4.948(2.89,8.449) 5.53(3.12,9.79) < 0.001 within one hour (early) 19 103 1 Have ever heard about bottle feeding No(not informed) 161 192 4.64(2.58, 8.36) 4.13(2.21,7.73) < 0.001 Yes(informed) 15 83 1 Discussion The aim of this study was to assess the prevalence of bottle-feeding practice and associated factors among infants less than six months in Addis Ababa public health centers. In this study, the prevalence of bottle-feeding practice was 39%( 95%CI: 35–44). This result is consistent with the studies done at East Africa(Comoros)( 19 ), Sudan( 20 ) and Woldia, Ethiopia( 16 ). On the other hand, the result of this study is higher compared to the national prevalence reported in the 2019 EDHS 22%( 21 ), studies conducted at Mettu town( 7 ), Namibia( 22 ), Nine East and south east Asian countries( 23 ) and Nigeria( 24 ). The possible reason for this difference might be attributed to study period variation, as there has been increasing advocacy for using formula in this region recently and urbanization. In contrast, The prevalence of bottle feeding in this study is lower than studies conducted at Debrelibanos Ethiopia ( 25 ), Pakistan( 11 ) and Nine east and south east Asian countries(Philippines)( 23 ). The difference might be due to methodological variations between studies, dissimilarities in infant and maternal socio-demographic characteristics and other differences in sociocultural, economical, health and health service utilization characteristics between respondents of the referenced areas and the study place. The main reasons mentioned by mothers for bottle feeding in this study are insufficient breast milk production for infants (30.6%), short maternity leave (22%), and maternal work load in house and outside house to breast feed (17.2%), maternal illness (17.7%) and infant refusal to breast feed due to childhood illness (13.40%). These results are consistent with other studies done in Holata ( 2 ), Agaro ( 10 ), Namibia( 22 ), Benghazi Libya( 26 ), Mauritius( 27 ) and Pakistan( 11 ). Short maternal leave (3 months) makes mothers prompted to resort to the supplementation of infant formula before 3 months so that their infants familiarize to bottle feeding during their absence, resumption of work, perception of breast milk insufficiency and infants sucking problem are factors that hiders breast feeding and facilitates for choosing bottle feeding. According to this study, mothers who gave birth through cesarean section were 2.8 times more likely to practice bottle feed than mothers give birth via spontaneous delivery. This result is in line with studies conducted at Namibia( 22 ), Libya( 26 ), Pakistan( 11 )and India( 9 ). This resulted due to delayed initiation of breast feeding because of mothers take long time to recover from anesthesia and additional discomfort. Similarly, sex of the infant was significantly associated with bottle feeding practice. An infant who is male was 59% less likely to bottle feed than infants of female sex. This result is similar with studies done in India( 9 ), this is due to mothers belief of males high nutritional requirement construction of gender influence to increase bottle feeding. Among the various obstetric and health service utilization factors assessed, infant hospitalization was significantly associated with bottle feeding practice. Infants who were hospitalized after delivery were almost 2 times more likely to practice bottle feeding than infants who were not hospitalized. This result is similar with studies done in India( 9 ), Kassel, eastern Sudan( 20 ) and Ethiopia particularly Holeta( 2 ) and Agaro towns( 10 ). This may result due infants sucking problem as result of childhood illness that makes them to admit to hospital. Late initiation breast feed was significantly associated with bottle feeding practice. Mothers who initiate breast fed after one hour were 5.5 times more likely to practice bottle feeding than mothers who initiate breast feed immediately after birth (within one hour). This result is in line with studies done in Wuhan, China, ( 28 ), Hula (sidama Ethiopia)( 29 ) and Debra Birhan, Ethiopia ( 30 ). This might be due maternal illness (pain full breast experience), delayed milk secretion, caesarean section mode of delivery, infant inability to suck breast and low counseling service during ANC and PNC. Access to information seems to affect a mother’s decision on infant and young child feeding. Mothers who have no information on bottle feeding was significantly associated with bottle feeding practice. Mothers who haven’t information about risk of bottle feeding were 4 times more likely to practice bottle fed than mothers having information about bottle feeding [AOR = 4.131(95%CI: 2.208, 7.729)]. This study supports study conducted in in Benghazi, Libya ( 27 ). This may be resulted due to lack of information about benefits of breastfeeding for mother and child and risks followed after bottle feeding like diarrhea and other botte sanitation related infections. Finally, lack of indication on seasonal variation of bottle feeding, inclusion of only governmental health centers and qualitative method of study was limitation this study. Conclusion The overall prevalence of bottle feeding practice high in the study area (39%) as compared to national prevalence (22%). male infant, infant hospitalized, cesarean section delivery and late initiation of breastfeeding. infant hospitalization and late initiation of breast feeding and not having information on bottle feeding were significant factors associated with bottle feeding practice. Therefore, increasing breast feeding practice and avoid bottle feeding practice, provide continuous breastfeeding education, training of health care workers to strengthen maternal and child health services increase maternity leave are recommendations of the study. Abbreviations AOR Adjusted odds ratio ANC Antenatal care BF Bottle feeding CSA Central statistics agency CI Confidence interval COR crud odds ratio ETB Ethiopian birr EC Ethiopian calendar EDHS Ethiopian demographic and healthy survey EPI Expanded program of immunization HR Hazards ratio HC Health center IYCF Infant and young child feeding NGO non-governmental organization RR Relative risk SRS Simple random sampling SPSS Statistical package for social science WHO World health organization. Declarations The study was conducted after getting Ethical clearance from the Institutional Review Board of Saint Paul hospital millennium medical collage ethical review committee (reference number PML3/757, on 9/6/2022) and Addis Ababa health bureau public health research and emergency management department(reference number A/A/16172/227, on 23/6/2022). The participants were then fully briefed about the study’s purpose and benefits in their local language and obtained informed written consent for both data collection and publication. Confidentiality was maintained through anonymity and privacy measures were taken to preserve the right of the participants throughout the research work including publication. Finally, the selected participants were asked about their willingness to join the study. Any study participant willing to engage in the study and those who wanted to stop an interview at any time were allowed to do so. This study was conducted in accordance with the Declaration of Helsinki. Consent for publication : Not applicable Availability of data and materials : The datasets analyzed during the current study are available from the corresponding author upon reasonable request. Competing interest : the authors declare that they have no competing interest. Funding: There were no external organizations that funded this research. Authors’ contribution : GB developed the project, manage resource, and perform supervision and investigation. GB, ST, SM, AA 3 , BM and AB, participated in the methodology. GB, SM, ST, AA 2 , AA 3 in data analysis and conceptualization (developing the initial drafts of the manuscript) and revising subsequent drafts. GB, AA 2 and SM prepared the final draft of the manuscript. All authors read and approved the final manuscript. Acknowledgment We would like to thank Saint Paul hospital millennium medical collage to support this research project. 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Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age : A hospital-based study in Woldia , Ethiopia with Bottle Feeding Practices in Infants. 9(1). Ekubagewargies D, … HM-I journal of, 2019 undefined. Assessment of Knowledge, Attitude, and Practice of HIV Positive Mothers on Antiretroviral Treatment towards Infant Feeding in Gondar Town Health Institutions, North. HindawiCom [Internet]. 2019;2019. Available from: https://www.hindawi.com/journals/ijpedi/2019/9107989/abs/ Mihret Y, Endalew F, Almaw H, Linger M. Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age: A hospital-based study in Woldia, Ethiopia. Cent Asian J Glob Heal. 2020;9(1). Birhan NA, Alene M. Pooled Prevalence and Determinants of Prelacteal Feeding Practice in Eastern Africa Evidence from Demographic and Health Survey Data : A Multilevel Study. 2021;1085–1095:1085–95. Hassan AA, Hassan AA, Taha Z, Abdulla MA, Ali AA, Adam I. Assessment of Bottle-Feeding Practices in Kassala , Eastern Sudan : A Community-Based Study Assessment of Bottle-Feeding Practices in Kassala , Eastern Sudan : A Community-Based Study. 2019;(January 2021). Ethiopian Public Health Institute (EPHI), ICF. Ethiopia Mini Demographic and Health Survey 2019: Final Report [Internet]. 2021. 1–207 p. Available from: https://dhsprogram.com/pubs/pdf/FR363/FR363.pdf Berde AS. Factors associated with bottle feeding in Namibia: Findings from Namibia 2013 demographic and health survey. J Trop Pediatr. 2018;64(6):460–7. Dibley MJ, Senarath U, Agho KE. Infant and young child feeding indicators across nine East and Southeast Asian countries : An analysis of National Survey Data 2000-2005 Infant and young child feeding indicators across nine East and Southeast Asian countries : an analysis of National Sur. 2010;(May). Akinyinka M. Breastfeeding Knowledge and Practices among Mothers of Children under 2 Years of Age Living in a Military Barrack in Southwest Nigeria. Int J MCH AIDS. 2016;5(1):1–13. Id MM, Kinati T, Bekele K, Tesfa B, Hailu D. Infant and young child feeding practice among mothers of children age 6 to 23 months in Debrelibanos district , North Showa. 2021;1–14. Available from: http://dx.doi.org/10.1371/journal.pone.0257758 Motee A, Ramasawmy D, Pugo-Gunsam P, Jeewon R. An assessment of the breastfeeding practices and infant feeding pattern among mothers in mauritius. J Nutr Metab. 2013;2013. Abdulmalek LJ. Factors affecting exclusive breast feeding practices in Benghazi , Libya Factors affecting exclusive breast feeding practices in Benghazi , Libya. 2018;(March). Huang L, Xu S, Chen X, Li Q, Lin L, Zhang Y, et al. Delayed Lactogenesis Is Associated with Suboptimal Breastfeeding Practices : A Prospective Cohort Study. 2019;(13):1–7. Breastfeeding S, Shibru H, Hoche S, Meshesha B, Wakgari N. Sub-Optimal Breastfeeding and Its Associated Factors in Rural Communities of Hula District , Southern Ethiopia : A Cross-Sectional Study. Gultie T, Sebsibie G. Determinants of suboptimal breastfeeding practice in Debre Berhan town, Ethiopia: a cross sectional study. Int Breastfeed J [Internet]. 2016;1–8. Available from: http://dx.doi.org/10.1186/s13006-016-0063-z Additional Declarations The authors declare potential competing interests as follows: All authors are listed in accordance with their contribution Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6635963","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":454752090,"identity":"bde0638b-c965-4c70-b924-99e8eb212415","order_by":0,"name":"Gedefaw Birhan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYHACA4YKBoYENgYeIBvIYmBmbiCs5QxcyxmQFkYitTCAtDC2gQQIaJF3b9744EDN4Tw+6bMHPxfOq43mbwdq+VGxDacWwzPHig0OHDtczMaXlyw9c9vx3BmHGRsYe87cxq1lRo6Z9Ae224ltPDwG0rzbjuU2ALUwM7bh0TL/jfmPA//AWox/8845ljufkBZ5CR4zhoNtYC1m0rwNNbkbCGkx4EkrljjY97+YDajFmufYgdyNQC0H8flFvv3wxg8HvqXlyffwGN/mqanLnXf+8MEHPyrw2HIAlX8YTB7AUIdsSwMqvw6f4lEwCkbBKBihAAD0cl3dInHy1wAAAABJRU5ErkJggg==","orcid":"","institution":"Addis Ababa university, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.","correspondingAuthor":true,"prefix":"","firstName":"Gedefaw","middleName":"","lastName":"Birhan","suffix":""},{"id":454752091,"identity":"c2745d59-0d07-4ac1-bece-1a8ccbd3d6f7","order_by":1,"name":"Shikur Mohamed","email":"","orcid":"","institution":"Saint paul hospital millenium medical college, Addis Ababa, Ethiopia.","correspondingAuthor":false,"prefix":"","firstName":"Shikur","middleName":"","lastName":"Mohamed","suffix":""},{"id":454752092,"identity":"f78ddbc6-7086-444a-b95e-10ba85f592d6","order_by":2,"name":"Sisay Tenia","email":"","orcid":"","institution":"Saint paul hospital millenium medical college, Addis Ababa, Ethiopia.","correspondingAuthor":false,"prefix":"","firstName":"Sisay","middleName":"","lastName":"Tenia","suffix":""},{"id":454752093,"identity":"65dc1dfa-c129-49f2-8dee-0a744eb7804b","order_by":3,"name":"Mulugeta Taybele","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+0lEQVRIiWNgGAWjYFAC5gYIzd7Y+CChAiQAE8EJGEEKDBh4eA43G3w4A9LCSKwWifQ2yZltcBHcQHdGYpvkl4o/8vYMiQ3SvPNqo/nbgVp+VGzDqcXsRmKbtMwZA8MehoMNxrzbjufOOMzYwNhz5jZ+LZJtBow9jI0NybzbjuU2ALUwM7YR0vLPwL4H6OvDvHOO5c4nRovkxwaDxB42xsbGmQ01uRsIajnzsNma4Zhxcs8ZxmaGD8cO5G4EajmI1y/Hkw/e/FEjZ9s+//nzHwk1dbnzzh8++OBHBW4tIMDMg2AfBpMH8KoHAsYfCHYdIcWjYBSMglEwAgEA76xiLycOggcAAAAASUVORK5CYII=","orcid":"","institution":"Armed forces comprehensive specilized hospital, Addis Ababa, Ethiopia.","correspondingAuthor":true,"prefix":"","firstName":"Mulugeta","middleName":"","lastName":"Taybele","suffix":""},{"id":454752094,"identity":"e29789f2-e0ae-4b58-b047-75d04f906c42","order_by":4,"name":"Belete Mengistu","email":"","orcid":"","institution":"Armed forces comprehensive specialized hospital, Addis Ababa, Ethiopia.","correspondingAuthor":false,"prefix":"","firstName":"Belete","middleName":"","lastName":"Mengistu","suffix":""},{"id":454752095,"identity":"6567b1ea-0af7-411a-9b90-a85f7316324b","order_by":5,"name":"Amanuel Alem","email":"","orcid":"","institution":"Armed forces comprehensive specialized hospital, Addis Ababa, Ethiopia.","correspondingAuthor":false,"prefix":"","firstName":"Amanuel","middleName":"","lastName":"Alem","suffix":""},{"id":454752096,"identity":"5d8a3a5f-59a0-4910-a5f5-af0b5b01d5ba","order_by":6,"name":"Amlaku Alemante","email":"","orcid":"","institution":"Eka kotebe general hospital, Addis Ababa, Ethiopia.","correspondingAuthor":false,"prefix":"","firstName":"Amlaku","middleName":"","lastName":"Alemante","suffix":""}],"badges":[],"createdAt":"2025-05-10 16:40:01","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6635963/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6635963/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82609323,"identity":"719b9f55-a72a-4318-8423-128057103174","added_by":"auto","created_at":"2025-05-13 10:28:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":12860,"visible":true,"origin":"","legend":"\u003cp\u003ePercent distribution of prevalence bottle feeding practice' among mothers who have infant less than six months old in Addis Ababa, Ethiopia, 2022.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-6635963/v1/1080b3e7cdf4d7c1c92a57e2.png"},{"id":82609984,"identity":"e00e9d65-1e7c-4b88-8243-bfbb34cf97e1","added_by":"auto","created_at":"2025-05-13 10:36:15","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":20950,"visible":true,"origin":"","legend":"\u003cp\u003ePercent distribution of reasons to practice' bottle feeding among mothers who have infant less than six months old in Addis Ababa, Ethiopia, 2022.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-6635963/v1/aebd9b118e4374b43c8d6b15.png"},{"id":82611191,"identity":"c65bebd7-1e50-4999-8555-2ff9c3fd5a56","added_by":"auto","created_at":"2025-05-13 10:52:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1199619,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6635963/v1/11770d9d-b722-4a4f-9d9f-760971f3328f.pdf"}],"financialInterests":"The authors declare potential competing interests as follows: All authors are listed in accordance with their contribution","formattedTitle":"\u003cp\u003ePrevalence of bottle feeding practice and its associated factors among mothers of infants age less than six months in Addis Ababa, Ethiopia, 2022. Multi center cross sectional study.\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAdequate nutrition during the first two years of a child\u0026rsquo;s life is essential to lower morbidity and mortality, reduce the risk of chronic diseases, normal development and the future well-being of the child(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The World Health Organization (WHO) recommends Optimal infant and young child feeding practices which includes early initiation of breastfeeding within an hour of birth, exclusive breastfeeding up to six months of age, introduction of complementary feeding at six months and continuing breast-feeding up to 2 years or beyond and ensuring proper use of breast-milk substitutes(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBottle-feeding is an infant feeding modality that has been in existence since ancient times and currently a significant number of infants are being fed via a bottle with either breast milk or breast milk substitutes (formula)(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Globally, 59% of infants and around 85% of infants within Australia by five months of age are being fed with either breast milk or formula using bottles(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Breastfeeding is declining in almost all over the world despite its nutritional and immunological advantages. Improper breastfeeding practices may significantly compromise the health, development and survival of infants, children, and mothers(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Worldwide it causes 820,000 children and 20,000 maternal deaths in a year. It has been also found that non-exclusive breast-feeding (bottle feeding) in the first 6 months of life results in 1.4\u0026nbsp;million deaths and 10% of the disease burden in children younger than 5 years(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBottle feeding practices in infancy and childhood led to the high prevalence of malnutrition, increased morbidity and mortality in children in the developing world(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Malnutrition accounts for around two-thirds of all deaths among children under the age of five worldwide. Each year more than 10\u0026nbsp;million children die as a result of malnutrition; 98% of these deaths occur in underdeveloped countries(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Death rates in third world countries are lower among breastfed babies and breastfed babies have lower infections than formula fed babies(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn Ethiopia suboptimal breastfeeding practices are the most contributor around 70,000 infant deaths per year; 24% of the total infant death annually and that be significantly prevented by nutrition interventions such as exclusive breastfeeding(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Bottle feeding is one of the major causes of diarrhea among the infants. The rate of bottle- feeding practice keeps on increasing among the mothers with infants older than four months due to early weaning(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The major reasons for bottle- feeding practice include insufficient breast milk, the need to go back to work, maternal work load and illness, delayed ANC follow up, caesarean section mode of delivery and improper birth spacing (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan additionalcitationids=\"CR10 CR11 CR12\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eEven though, WHO recommends avoidance of bottle feeding, there is a current shift from traditional feeding practice(bottle feeding) towards shorter breast feeding and introduction of bottle-feeding in developed countries and urban communities of developing countries (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Practice of bottle feeding and associated factors are rarely addressed in urban community of Ethiopia including Addis Ababa. So, this study aimed to fill this gap and assess the prevalence of bottle-feeding practice and associated factors among mothers of infants less than six month in Addis Ababa, Ethiopia.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy area and period\u003c/h2\u003e \u003cp\u003eThe study was conducted in selected public hospitals of Addis Ababa, Ethiopia. There are 41 hospitals in Addis Ababa, including 13 public and 28 private ones. Out of the 13 government hospitals 03 public hospitals was selected for this study and out of 28 private hospitals 07 hospitals was selected for our study. The city has almost 4 per cent of the Ethiopian populations with 11 per cent of under five-year children. The total population of Addis Ababa is 3,602,000; 1,134,150 are under five children according to 2019 projection based on the 2007 census(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). In Addis Ababa there are around 116 health centers in eleven sub cites (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eStudy Design\u003c/strong\u003e \u003cp\u003eAn institutional based cross sectional study design was conducted\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Population and eligible criteria\u003c/h3\u003e\n\u003cp\u003eAll mothers who have infants less than six months in Addis Ababa were considered in the study. Those mothers who have infants less than six months at selected hospital were included in the study. Mothers who have repeated visits during the study period will be excluded from the study.\u003c/p\u003e\n\u003ch3\u003eSample Size Determination\u003c/h3\u003e\n\u003cp\u003eThe sample size required for the study is calculated using epi info application or the formula of simple proportion estimation: n\u0026thinsp;=\u0026thinsp;n = [(Z\u003csub\u003eα/2\u003c/sub\u003e)\u003csup\u003e2\u003c/sup\u003e (p) (1-p)]/d\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eWhere; n- The minimum sample size required, P- proportion of bottle feeding associated factor in study done at woldia hospital, maternal age 35\u0026ndash;50 years (23.4%)(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Z\u0026#120572;2\u0026frasl;- Standard normal value at (1- α) 95% confidence level, = 95%, margin of error (d)\u0026thinsp;=\u0026thinsp;5% and design effect (de)\u0026thinsp;=\u0026thinsp;1.5 is used,\u003c/p\u003e \u003cp\u003eThe sample size \u0026ldquo;n\u0026rdquo; for associated factor of bottle feeding = (1.96)\u003csup\u003e2\u003c/sup\u003e(0.234) (1-0.234)/ (0.05)\u003csup\u003e2\u003c/sup\u003e = 275, since study uses multi stage sampling, 1.5 design effect was used then the sample size would be 414.The final sample size after addition of 10% non-response rate was 456.\u003c/p\u003e\n\u003ch3\u003eSampling technique\u003c/h3\u003e\n\u003cp\u003eMulti stage sampling technique was employed to include study participants in to the research. The registration of mothers who have infant less than 6 months on expanded program of immunization register was used to get list of children from each Hospital. Sample from each hospital was determined by using proportion allocation to the sample size.\u003c/p\u003e \u003cp\u003eFinally, systematic random sampling technique was used to select a representative population in the immunization unit. The sampling interval (K) was established by dividing the average number of women who visited the immunization unit in the previous two months before data collection (average n\u0026thinsp;=\u0026thinsp;2660) by the sample size, which produced K\u0026thinsp;=\u0026thinsp;2660/456\u0026thinsp;=\u0026thinsp;6. Women were recruited daily by simple random sampling technique using the lottery method, and the next respondent was selected by adding a sampling interval to the number of the selected women. The same procedure was done on subsequent days until the required sample size was reached.\u003c/p\u003e\n\u003ch3\u003eProportional allocation\u003c/h3\u003e\n\u003cp\u003eIn three selected sub cities there were 2660 children less than 6 months of age. Out of this 335 in Beta health center, 277 in Simegn Kebede health center from Areda sub city, 360 in woreda 1 health center, 431 in woreda 3 health center and 245 from woreda 4 health center of Kolife Karanio sub city and 365 in woreda 2 health center, 347 woreda 10 health center and 300 from woreda 5 health center of Nifas silk lafito sub city.\u003c/p\u003e \u003cp\u003eBased on proportional allocation to size, 456 study subjects were distributed to Beta health center (57), Simegn Kebede health center(47) from Areda sub city; woreda 1 health center (42), woreda 3 health center(74) and woreda 4 health center(62) of Kolife Karanio sub city and woreda 2 health center (63), woreda 10 health center (60) and 300 from woreda 5 health center(51) of Nifas silk lafito sub city.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedure\u003c/h2\u003e \u003cp\u003eData was collected by face-to-face interview using semi-structured pretested questionnaire. The questionnaire was administered through face-to-face interview by five (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) trained data collectors (diploma nurse) and the data collection was supervised by two BSC health worker.\u003c/p\u003e \u003cp\u003eThe questionnaire was constructed by adopting and modifying from previous studies(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). First, the questionnaire was prepared in English then translated into Amharic (local language) and then back to English to check consistency.\u003c/p\u003e \u003cp\u003eThe quality of the data collection process was monitored, and clear uniform instructions were given to all data collectors. All data collected as a part of this study was checked by the principal investigator.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eOperational definitions\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eExclusive breastfeeding\u003c/strong\u003e \u003cp\u003eA mother gives to infant only breast milk (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eMaternal illness\u003c/b\u003e: Mothers difficulty to breastfeed an infant due to illness(breast illness related problem) (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). \u003cb\u003eMixed breastfeeding\u003c/b\u003e: if an infant took breast milk with addition of liquid foods like cow milk and formula milk and soft foods(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eAdequate knowledge\u003c/strong\u003e \u003cp\u003eIf a mother answers half and above correctly from questions which are asked to measure bottle feeding knowledge (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eInadequate knowledge\u003c/strong\u003e \u003cp\u003eIf a mother answers below half correctly from questions which are asked to measure bottle feeding knowledge (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eLate initiation of breastfeeding\u003c/strong\u003e \u003cp\u003einitiation of breast milk after one hour after delivery(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eBottle feeding\u003c/strong\u003e \u003cp\u003eMother uses bottle for Brest milk and or breast milk substitutes (formula or others)(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e\n\u003ch3\u003eData Quality Control\u003c/h3\u003e\n\u003cp\u003eThe principal investigator undergoes quality assessment on ongoing supervision each day during data collection to ensure quality of data by checking filled format for their completeness\u0026rsquo;s and consistency. Data reliability was checked by considering the Cronbach alpha which is greater than or equal to 0.5 and Multicollinearity between variables was also checked by considering variance inflation factor (VIF) which is less than 2 which indicates there is no correlation between independent variables.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData management and analysis\u003c/h2\u003e \u003cp\u003eData obtained from institution-based survey was checked for completeness \u0026amp; inconsistencies, then coded, entered and cleaned in the Epi info version 7.1 and Microsoft excel and analyzed using Statistical package for Social Sciences (SPSS) version 26. After categorizing and defining variables, descriptive analysis was carried out for each of the independent variables using frequencies, cross tabulation and percentages: then presented by text, tables and chart.\u003c/p\u003e \u003cp\u003eBinary logistic regression analysis model was used to assess the association between bottle feeding and associated factors. Variables with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.2 in bivariable binary logistic regression analysis were entered to multivariable binary logistic regression analysis. Finally, variables with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in multivariable logistic regression were taken as significant factor. Adjusted odds ratio with 95% CI was used to show the strength of association between the dependent and independent variables. Model fitness was tested with Hosmer and Lemeshow Goodness of Fit test and fit with a p-value\u0026thinsp;=\u0026thinsp;0.440. In addition, there was no problem of Multicollinearity among explanatory variables, with variance inflation factor\u0026thinsp;\u0026lt;\u0026thinsp;3 for all variables.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations\u003c/h2\u003e \u003cp\u003e Ethical clearance was obtained from the institutional review board of Saint Paul hospital millennium medical collage ethical review committee (ref.no. PML3/757, on 9/6/2022) and Addis Ababa health bureau public health research and emergency management department (ref.no. A/A/16172/227, on 23/6/2022). The participants were then fully briefed about the study\u0026rsquo;s purpose and benefits in their local language and obtained informed written consent for both data collection and publication. Confidentiality was maintained through anonymity and privacy measures were taken to preserve the right of the participants throughout the research work including publication. Finally, the selected participants were asked about their willingness to join the study. Any study participant willing to engage in the study and those who wanted to stop an interview at any time were allowed to do so. This study was conducted in accordance with the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic characteristics\u003c/h2\u003e \u003cp\u003eIn this study, a total of 451 study participants were included with a response rate of 98.9%. Among the study participants most of the study participants, 444 (98.4%) were married. Regards to religion more than half 235 (52.1%) were orthodox. Related to occupation, 202 (44.8%) of mothers were house wife. \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics mothers (respondents) who have infants less than six months old, in Addis Ababa: Ethiopia, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories(N\u0026thinsp;=\u0026thinsp;451)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003efrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMothers age(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eabove 35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e98.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eorthodox Christian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eunable to read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esecondary and preparatory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eHusbands\u0026rsquo; education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eunable to read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esecondary and preparatory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eMaternal occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egovernment employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprivate organization employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003edaily labor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eHusbands\u0026rsquo; occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egovernment employ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprivate organization employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003edaily labour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMonthly household income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1500\u0026ndash;4500 birr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4501\u0026ndash;7500 birr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7501\u0026ndash;10000 birr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eabove 10001birr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eOthers\u0026thinsp;=\u0026thinsp;single and divorced N\u0026thinsp;=\u0026thinsp;number\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eObstetric and health service utilization factors\u003c/h2\u003e \u003cp\u003eIn this study, 449 (99.6%) mothers had antenatal care in their previous pregnancy. During their antenatal care follow up, 87 (19.6%) of women did not receive counseling about infant feeding practice. The majority of the respondents 437(96.9%) were give birth at health institution and 14 (3.1%) were give birth at home. From 356(78.9%) of mothers received postnatal care, 289 (69.2%) had received counseling on infant feeding up to six months \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eObstetric and health service utilization characteristics of study participants in Addis Ababa, Ethiopia, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse (N\u0026thinsp;=\u0026thinsp;451)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003efrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInfant age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;3 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u0026ndash;6 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInfant sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e268\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eNumbers of children\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSix and above 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eBirth order\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFirst\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecond\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThird\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efourth and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eBirth interval from preceding birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eabove 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eANC follow up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e449\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e99.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eReceive infant feeding counseling during ANC visit(N\u0026thinsp;=\u0026thinsp;449)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e362\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehealth institution\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e437\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e96.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMode of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecesarean section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003espontaneous delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInfant hospitalization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePNC follow up within 45 days of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ereceive infant feeding counseling during PNC visit(N\u0026thinsp;=\u0026thinsp;356)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e289\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eN\u0026thinsp;=\u0026thinsp;number\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of bottle feeding practice\u003c/h2\u003e \u003cp\u003ePrevalence of Bottle feeding practice was 39% (95%CI 35, 44). The following figure shows the prevalence of bottle feeding practice among mothers who have infants less than six month (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Among respondents who used bottles for feeding, 103 (58.9%) used formula, 30(20.8%) used expressed breast milk and 5(3.5%) used caws milk. In this study influential bodies of mothers to start bottle fed were health professional 67(30.7%), husbands 40(18.3%) and mothers 17(7.8%) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eBottle feeding related factors\u003c/h2\u003e \u003cp\u003eAll mothers have breastfeed their current infant for a certain period of time. From total, 122 (27.1%) mothers initiated breast milk to infant immediately within one hour of birth and 131(29%) mothers initiated breast milk to infant after one hour of birth, where as103(22.8%) initiates breast feeding after mother feels comfort after delivery. In this study, Influential bodies of mothers to start bottle feeding were health professional 67(30.7%), husbands 40(18.3%) and mothers 17(7.8%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBottle feeding related practices of mothers who have infants less than six months old in Addis Ababa: Ethiopia, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eInitiation of breast feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eimmediately after birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eafter one hour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ewhen mother feels comfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI did not feed breast milk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKinds of fluid you feed if not breast feed(N\u0026thinsp;=\u0026thinsp;144)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecaws milk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eformula milk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eexpressed breast milk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eYoungest infant currently feed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ebreast feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ebottle feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBottle feeding(N\u0026thinsp;=\u0026thinsp;451)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDuration of bottle feed(N\u0026thinsp;=\u0026thinsp;156)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;3 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u0026ndash;6 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eInfluence to bottle feed (N\u0026thinsp;=\u0026thinsp;218)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eown decision\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHusband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehealth professionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efriends or family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe following diagram also shows the reason why mother who have infants less than six month practice bottle feeding (n\u0026thinsp;=\u0026thinsp;209) \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eMothers\u0026rsquo; knowledge and information source of bottle feeding\u003c/h2\u003e \u003cp\u003eAround two third (61.4%) of mother's who have infant less than six month have adequate knowledge on bottle feeding, where as 38.6% of mother's who have infant less than six month haven\u0026rsquo;t adequate knowledge on bottle feeding.\u003c/p\u003e \u003cp\u003eRegarding to information about bottle feeding 352(78.3%) mothers were informed about bottle feeding from different sources (Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInformation and source information on bottle feeding among mothers who have infants less than six months old in Addis Ababa: Ethiopia, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHave you ever heard bottle feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes(informed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo (not informed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eSource of information on bottle feeding(N\u0026thinsp;=\u0026thinsp;353)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emass media\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehealth facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efriends and family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ebooks and leaflets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMaternal knowledge on bottle feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003einadequate knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eadequate knowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e277\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e61.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eFactors associated with bottle feeding practice\u003c/h2\u003e \u003cp\u003eBinary logistic regression model was used to determine the association between independent variables with dependent variable. Variables which were associated with bottle feeding practice in the bivariable binary logistic regression analysis (P\u0026thinsp;\u0026lt;\u0026thinsp;0.2) were; sex of infant, initiation of breast milk, mothers education, place of delivery, mode of delivery, monthly household income, infant hospitalization, information herd about bottle feeding and mothers knowledge about bottle feeding. Variables which were associated in bivariable binary logistic regression analysis were tested in the final multivariable binary logistic regression analysis to see their significant association with bottle feeding practice.\u003c/p\u003e \u003cp\u003eBy using backward likelihood ratio method multivariable logistic regression analysis; infant sex, infant hospitalization, mode of delivery, heard about bottle feeding and initiation of breast milk were remained significant in the final model. Model fitness was tested with Hosmer and Lemeshow Goodness of Fit test and fit with a p-value\u0026thinsp;=\u0026thinsp;0.440. In addition, there was no problem of Multicollinearity among explanatory variables, with variance inflation factor\u0026thinsp;\u0026lt;\u0026thinsp;3 for all variables.\u003c/p\u003e \u003cp\u003eAfter adjusting confounding variables the finding of this study revealed that the odds of bottle feeding practice among mothers having infants less than six months who had male infant were 59% less likely to bottle feed than infants of female sex [AOR\u0026thinsp;=\u0026thinsp;0.589(95%CI: 0.381, 0.911)].\u003c/p\u003e \u003cp\u003eMode of delivery was significantly associated with bottle feeding practice. mothers who gave birth through cesarean section were 2.8 times more likely to practice bottle feed than mothers give birth via spontaneous delivery [AOR\u0026thinsp;=\u0026thinsp;2.817 (95%CI: 1.764, 4.494)]. Similarly, infant hospitalization after delivery is significant for mothers to bottle feed an infant. Infants who were hospitalized after delivery were almost 2 times more likely to practice bottle feeding than infants who were not hospitalized [AOR\u0026thinsp;=\u0026thinsp;2.114(95%CI: 1.246, 3.588)]. In addition, time of initiation breast feed was significantly associated with bottle feeding practice. Mothers who initiate breast fed after one hour were 5.5 times more likely to practice bottle feeding than mothers who initiate breast feed immediately after birth (within one hour) [AOR\u0026thinsp;=\u0026thinsp;5.526(95%CI: 3.121, 9.786)]. Furthermore, mothers who have no information on bottle feeding was significantly associated with bottle feeding practice. Lastly, Mothers not having information about bottle feeding were 4 times more likely to practice than mothers not having information about bottle feeding [AOR\u0026thinsp;=\u0026thinsp;4.131(95%CI: 2.208, 7.729)] (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariable and multivariable logistic regression analysis for factors associated with bottle feeding practice among mothers having infant less than 6 months at Addis Ababa health centers, Addis Ababa, Ethiopia, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c2\" namest=\"c1\" rowspan=\"3\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c7\" namest=\"c3\"\u003e \u003cp\u003eBottle Feeding\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCOR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInfant sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.64(0.436, 0.941)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.589(0.38,0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eunable to read and write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.476(0.21,1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.448(0.27,0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esecondary and preparatory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.657(0.40,1.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMonthly household income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1500\u0026ndash;4500 birr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.414(0.22, 0.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4501\u0026ndash;7500 birr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.320(0.18, 0.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7501\u0026ndash;10000 birr\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.528(0.29,0.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eabove 10001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehealth institution\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e173\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.403(0.66,8.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMode of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecaesarean section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.258(2.14,4.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.82(1.76, 4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003espontaneous delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eInfant hospitalization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.329(1.46,3.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.11(1.25,3.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTime of initiation of breast feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eafter one hour(late)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.948(2.89,8.449)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.53(3.12,9.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ewithin one hour (early)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHave ever heard about bottle feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo(not informed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.64(2.58, 8.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.13(2.21,7.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes(informed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aim of this study was to assess the prevalence of bottle-feeding practice and associated factors among infants less than six months in Addis Ababa public health centers. In this study, the prevalence of bottle-feeding practice was 39%( 95%CI: 35\u0026ndash;44). This result is consistent with the studies done at East Africa(Comoros)(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), Sudan(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and Woldia, Ethiopia(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). On the other hand, the result of this study is higher compared to the national prevalence reported in the 2019 EDHS 22%(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), studies conducted at Mettu town(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), Namibia(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), Nine East and south east Asian countries(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) and Nigeria(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). The possible reason for this difference might be attributed to study period variation, as there has been increasing advocacy for using formula in this region recently and urbanization. In contrast, The prevalence of bottle feeding in this study is lower than studies conducted at Debrelibanos Ethiopia (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), Pakistan(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) and Nine east and south east Asian countries(Philippines)(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The difference might be due to methodological variations between studies, dissimilarities in infant and maternal socio-demographic characteristics and other differences in sociocultural, economical, health and health service utilization characteristics between respondents of the referenced areas and the study place.\u003c/p\u003e \u003cp\u003eThe main reasons mentioned by mothers for bottle feeding in this study are insufficient breast milk production for infants (30.6%), short maternity leave (22%), and maternal work load in house and outside house to breast feed (17.2%), maternal illness (17.7%) and infant refusal to breast feed due to childhood illness (13.40%). These results are consistent with other studies done in Holata (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), Agaro (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), Namibia(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), Benghazi Libya(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), Mauritius(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) and Pakistan(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Short maternal leave (3 months) makes mothers prompted to resort to the supplementation of infant formula before 3 months so that their infants familiarize to bottle feeding during their absence, resumption of work, perception of breast milk insufficiency and infants sucking problem are factors that hiders breast feeding and facilitates for choosing bottle feeding.\u003c/p\u003e \u003cp\u003eAccording to this study, mothers who gave birth through cesarean section were 2.8 times more likely to practice bottle feed than mothers give birth via spontaneous delivery. This result is in line with studies conducted at Namibia(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), Libya(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), Pakistan(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)and India(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). This resulted due to delayed initiation of breast feeding because of mothers take long time to recover from anesthesia and additional discomfort. Similarly, sex of the infant was significantly associated with bottle feeding practice. An infant who is male was 59% less likely to bottle feed than infants of female sex. This result is similar with studies done in India(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e), this is due to mothers belief of males high nutritional requirement construction of gender influence to increase bottle feeding.\u003c/p\u003e \u003cp\u003eAmong the various obstetric and health service utilization factors assessed, infant hospitalization was significantly associated with bottle feeding practice. Infants who were hospitalized after delivery were almost 2 times more likely to practice bottle feeding than infants who were not hospitalized. This result is similar with studies done in India(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e), Kassel, eastern Sudan(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and Ethiopia particularly Holeta(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) and Agaro towns(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). This may result due infants sucking problem as result of childhood illness that makes them to admit to hospital.\u003c/p\u003e \u003cp\u003eLate initiation breast feed was significantly associated with bottle feeding practice. Mothers who initiate breast fed after one hour were 5.5 times more likely to practice bottle feeding than mothers who initiate breast feed immediately after birth (within one hour). This result is in line with studies done in Wuhan, China, (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), Hula (sidama Ethiopia)(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e) and Debra Birhan, Ethiopia (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). This might be due maternal illness (pain full breast experience), delayed milk secretion, caesarean section mode of delivery, infant inability to suck breast and low counseling service during ANC and PNC.\u003c/p\u003e \u003cp\u003eAccess to information seems to affect a mother\u0026rsquo;s decision on infant and young child feeding. Mothers who have no information on bottle feeding was significantly associated with bottle feeding practice. Mothers who haven\u0026rsquo;t information about risk of bottle feeding were 4 times more likely to practice bottle fed than mothers having information about bottle feeding [AOR\u0026thinsp;=\u0026thinsp;4.131(95%CI: 2.208, 7.729)]. This study supports study conducted in in Benghazi, Libya (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). This may be resulted due to lack of information about benefits of breastfeeding for mother and child and risks followed after bottle feeding like diarrhea and other botte sanitation related infections. Finally, lack of indication on seasonal variation of bottle feeding, inclusion of only governmental health centers and qualitative method of study was limitation this study.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe overall prevalence of bottle feeding practice high in the study area (39%) as compared to national prevalence (22%). male infant, infant hospitalized, cesarean section delivery and late initiation of breastfeeding. infant hospitalization and late initiation of breast feeding and not having information on bottle feeding were significant factors associated with bottle feeding practice. Therefore, increasing breast feeding practice and avoid bottle feeding practice, provide continuous breastfeeding education, training of health care workers to strengthen maternal and child health services increase maternity leave are recommendations of the study.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAdjusted odds ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eANC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntenatal care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBottle feeding\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCSA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCentral statistics agency\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConfidence interval\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ecrud odds ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eETB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEthiopian birr\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEthiopian calendar\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEDHS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEthiopian demographic and healthy survey\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEPI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eExpanded program of immunization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHazards ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealth center\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIYCF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInfant and young child feeding\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNGO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003enon-governmental organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRelative risk\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSRS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSimple random sampling\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical package for social science\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld health organization.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe study was conducted after getting Ethical clearance from the Institutional Review Board of Saint Paul hospital millennium medical collage ethical review committee (reference number PML3/757, on 9/6/2022) and Addis Ababa health bureau public health research and emergency management department(reference number A/A/16172/227, on 23/6/2022). The participants were then fully briefed about the study\u0026rsquo;s purpose and benefits in their local language and obtained informed written consent for both data collection and publication. Confidentiality was maintained through anonymity and privacy measures were taken to preserve the right of the participants throughout the research work including publication. Finally, the selected participants were asked about their willingness to join the study. Any study participant willing to engage in the study and those who wanted to stop an interview at any time were allowed to do so. This study was conducted in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e: The datasets analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e: the authors declare that they have no competing interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThere were no external organizations that funded this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e: GB developed the project, manage resource, and perform supervision and investigation. GB, ST, SM, AA\u003csup\u003e3\u003c/sup\u003e, BM and AB, participated in the methodology. GB, SM, ST, AA\u003csup\u003e2\u003c/sup\u003e, AA\u003csup\u003e3\u003c/sup\u003e in data analysis and conceptualization (developing the initial drafts of the manuscript) and revising subsequent drafts. GB, AA\u003csup\u003e2\u0026nbsp;\u003c/sup\u003eand SM prepared the final draft of the manuscript. All authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Saint Paul hospital millennium medical collage to support this research project. The authors would also like to extend their gratitude to Addis Ababa health centers, data collectors and supervisor for their valuable contribution. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eRahman A, Akter F. Reasons for formula feeding among rural Bangladeshi mothers : A qualitative exploration. 2019;1\u0026ndash;21. \u003c/li\u003e\n\u003cli\u003eKebebe T, Assaye H. Intention, magnitude and factors associated with bottle feeding among mothers of 0-23 months old children in Holeta town, Central Ethiopia: A cross sectional study. BMC Nutr. 2017;3(1):1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eWu H, Zhao M, Magnussen CG, Xi B. EClinicalMedicine Global prevalence of WHO infant feeding practices in 57 LMICs in 2010 \u0026Agrave; 2018 and time trends since 2000 for 44 LMICs. 2021;37:1\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eKotowski J, Fowler C, Hourigan C, Orr F. Bottle-feeding an infant feeding modality : An integrative literature review. Matern Child Nutr. 2020;(December 2019):1\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eMeranti D ikepulauan. Assesment ofexclusive breast feeding practice and associated factors among mothers in motta town, east gojam zone, Amhara reginal state, Ethiopia, 2015. 2015;II:1\u0026ndash;15. \u003c/li\u003e\n\u003cli\u003eDibley MJ, Senarath U, Agho KE. Infant and young child feeding indicators across nine East and Southeast Asian countries : An analysis of National Survey Data 2000-2005 Infant and young child feeding indicators across nine East and Southeast Asian countries : an analysis of National Survey Data 2000 \u0026ndash; 2005. 2010;(October 2014). \u003c/li\u003e\n\u003cli\u003eLicense RF. Formula Feeding and Associated Factors among Mothers with Infants 0-6 Months Old in Mettu Town ,. 2021;1\u0026ndash;19. \u003c/li\u003e\n\u003cli\u003eFMOH. National Strategy for Infant and Young Child Feeding. Ethiopia: Int J Innov Sci Res Technol. 2004;5(April):1504\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eMakwana DNK. Determinants of bottle feeding among 0-24 months children. Pediatr Rev Int J Pediatr Res. 2020;7(1):14\u0026ndash;21. \u003c/li\u003e\n\u003cli\u003eMoga TT, Haso TK, Shemsi S. Utilization of Bottle Feeding Practices and Associated Factors among Mothers Who Have Infant Less than 12months of Age in Agaro Twon iMedPub Journals Utilization of Bottle Feeding Practices and Associated Factors among Mothers Who Have Infant Less than 12. Heal Sci J. 2019;13(April). \u003c/li\u003e\n\u003cli\u003eScience F. Determinants of Child Feeding Practices in Pakistan ; Secondary Data Analysis of Demographic and Health Survey. 2014;2:1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eFikadu, A. Hailu N. C. Infant bottle feeding practice ,in Agaro: southwest Ethiopia. Ethiop J Heal scince. 2013;13,1:51\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eHassan AA, Taha Z, Abdulla MA, Ali AAA, Adam I. Assessment of bottle-feeding practices in kassala, eastern sudan: A community-based study. Open Access Maced J Med Sci. 2019;7(4):651\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eSituation Analysis of Children and Women: Addis Ababa. \u003c/li\u003e\n\u003cli\u003eHc W, Hc W, Hc W, Hc KT. SNNPR : Coverage of Health Facilities. 2013; \u003c/li\u003e\n\u003cli\u003eMihret Y, Almaw H. Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age : A hospital-based study in Woldia , Ethiopia with Bottle Feeding Practices in Infants. 9(1). \u003c/li\u003e\n\u003cli\u003eEkubagewargies D, \u0026hellip; HM-I journal of, 2019 undefined. Assessment of Knowledge, Attitude, and Practice of HIV Positive Mothers on Antiretroviral Treatment towards Infant Feeding in Gondar Town Health Institutions, North. HindawiCom [Internet]. 2019;2019. Available from: https://www.hindawi.com/journals/ijpedi/2019/9107989/abs/\u003c/li\u003e\n\u003cli\u003eMihret Y, Endalew F, Almaw H, Linger M. Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age: A hospital-based study in Woldia, Ethiopia. Cent Asian J Glob Heal. 2020;9(1). \u003c/li\u003e\n\u003cli\u003eBirhan NA, Alene M. Pooled Prevalence and Determinants of Prelacteal Feeding Practice in Eastern Africa Evidence from Demographic and Health Survey Data : A Multilevel Study. 2021;1085\u0026ndash;1095:1085\u0026ndash;95. \u003c/li\u003e\n\u003cli\u003eHassan AA, Hassan AA, Taha Z, Abdulla MA, Ali AA, Adam I. Assessment of Bottle-Feeding Practices in Kassala , Eastern Sudan : A Community-Based Study Assessment of Bottle-Feeding Practices in Kassala , Eastern Sudan : A Community-Based Study. 2019;(January 2021). \u003c/li\u003e\n\u003cli\u003eEthiopian Public Health Institute (EPHI), ICF. Ethiopia Mini Demographic and Health Survey 2019: Final Report [Internet]. 2021. 1\u0026ndash;207 p. Available from: https://dhsprogram.com/pubs/pdf/FR363/FR363.pdf\u003c/li\u003e\n\u003cli\u003eBerde AS. Factors associated with bottle feeding in Namibia: Findings from Namibia 2013 demographic and health survey. J Trop Pediatr. 2018;64(6):460\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eDibley MJ, Senarath U, Agho KE. Infant and young child feeding indicators across nine East and Southeast Asian countries : An analysis of National Survey Data 2000-2005 Infant and young child feeding indicators across nine East and Southeast Asian countries : an analysis of National Sur. 2010;(May). \u003c/li\u003e\n\u003cli\u003eAkinyinka M. Breastfeeding Knowledge and Practices among Mothers of Children under 2 Years of Age Living in a Military Barrack in Southwest Nigeria. Int J MCH AIDS. 2016;5(1):1\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eId MM, Kinati T, Bekele K, Tesfa B, Hailu D. Infant and young child feeding practice among mothers of children age 6 to 23 months in Debrelibanos district , North Showa. 2021;1\u0026ndash;14. Available from: http://dx.doi.org/10.1371/journal.pone.0257758\u003c/li\u003e\n\u003cli\u003eMotee A, Ramasawmy D, Pugo-Gunsam P, Jeewon R. An assessment of the breastfeeding practices and infant feeding pattern among mothers in mauritius. J Nutr Metab. 2013;2013. \u003c/li\u003e\n\u003cli\u003eAbdulmalek LJ. Factors affecting exclusive breast feeding practices in Benghazi , Libya Factors affecting exclusive breast feeding practices in Benghazi , Libya. 2018;(March). \u003c/li\u003e\n\u003cli\u003eHuang L, Xu S, Chen X, Li Q, Lin L, Zhang Y, et al. Delayed Lactogenesis Is Associated with Suboptimal Breastfeeding Practices : A Prospective Cohort Study. 2019;(13):1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eBreastfeeding S, Shibru H, Hoche S, Meshesha B, Wakgari N. Sub-Optimal Breastfeeding and Its Associated Factors in Rural Communities of Hula District , Southern Ethiopia : A Cross-Sectional Study. \u003c/li\u003e\n\u003cli\u003eGultie T, Sebsibie G. Determinants of suboptimal breastfeeding practice in Debre Berhan town, Ethiopia: a cross sectional study. Int Breastfeed J [Internet]. 2016;1\u0026ndash;8. Available from: http://dx.doi.org/10.1186/s13006-016-0063-z\u003cstrong\u003e\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Addis Ababa University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"bottle feeding, prevalence, associated factors, Addis Ababa, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-6635963/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6635963/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction\u003c/h2\u003e \u003cp\u003e: Bottle feeding practice should be avoided due to its influence on optimal breastfeeding and its effect associated with morbidity and mortality resulting from diarrheal disease, infant and child illness, and malnutrition. This study is aimed to assess the prevalence of bottle-feeding practice and its associated factors among mothers of infants less than six months in Addis Ababa.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn institution-based multi center cross-sectional study was conducted among 456 mothers who had infants less than six months in Addis Ababa visiting hospitals for MCH Service. Data were collected through interview, entered using Epi info version 7.1 and exported to statistical package for social science version 26 for analysis. Variables with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.25 in bivariable binary logistic regression analysis were entered to multivariable logistic regression analysis. Finally, variables with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in multivariable logistic regression were taken as significant factor.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe overall prevalence of bottle-feeding practice in Addis Ababa is 39%. Being male infant (AOR\u0026thinsp;=\u0026thinsp;0.589; 95%CI: 0.381, 0.911), infant hospitalization (AOR\u0026thinsp;=\u0026thinsp;2.114; 95%CI 1.246, 3.588), cesarean section delivery (AOR\u0026thinsp;=\u0026thinsp;2.817; 95%CI: 1.764, 4.496), late initiation of breastfeeding (AOR\u0026thinsp;=\u0026thinsp;5.526; 95%CI: 3.121, 9.786) and not having information on breast feeding (AOR\u0026thinsp;=\u0026thinsp;4.13; 95%CI 2.21, 7.73) were statistically significant factors associated with bottle feeding practice.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe magnitude of bottle-feeding practice is high in Addis Ababa. Being male infants, infants hospitalized, cesarean section delivery, late initiation of breastfeeding and not having information on breast feeding were significant factors for bottle feeding practice. Greater efforts to promote breastfeeding should be targeted towards women with sub-optimal breastfeed.\u003c/p\u003e","manuscriptTitle":"Prevalence of bottle feeding practice and its associated factors among mothers of infants age less than six months in Addis Ababa, Ethiopia, 2022. 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